Time For New Zealand To Learn From Cuba On Vaccine Production

Monday, 29 August 2022, 7:02 am
Opinion: Ian Powell

On 10 June 2021 the Democracy Project published my article on lessons that Aotearoa New Zealand should learn from Cuba’s extraordinary progress in Covid-19 vaccine production: Is Cuba the Covid-19 vaccine powerhouse?. The vaccine powerhouse reference was a descriptor used earlier by the Washington Post.

Three of the five vaccines were developed by the Finlay Institute of Vaccines in partnership with the Centre for Molecular Immunology (Soberana01 and 02, and Soberana Plus). The other two were developed by the Centre of Genetic Engineering and Biotechnology (Abdala and Mambisa).

Of all the reputable English language medical journals in the world, for me the three most prominent ones are the British Medical Journal, New England Journal of Medicine and the United Kingdom based The Lancet. It is a matter of personal pride that the first of these three (BMJ) published an article I co-authored in 2015.

Now, on 9 June 2022 the third of the trio, The Lancet, has published a clinical article on subsequent Cuban Covid-19 vaccine development:  Safety and immunogenicity of Cuban vaccine. 

Significant increase in functional antibodies

It is not easy to get an article published by The Lancet because of its rigorous standards, including independent peer review. The article, written by Cuban medical specialists and scientists, had to meet a high threshold for publication and they met it. The focus of the article is on the work of the Finlay Institute of Vaccines.

Its conclusion was that Soberana proved to be a:

… a safe, effective, and immunogenic vaccine. No serious vaccine-associated adverse events were reported. Minor adverse events, especially local pain, were the most common. A strong booster immune response was also shown. Most individuals had a significant increase in functional antibodies, including live-virus neutralising activity.

Even a poor country subjected to economic warfare can make vaccines

Nine days later the Washington Post published an article on Cuba’s Covid-19 vaccines for children: Cuba a Covid-19 vaccine pioneer for kids.

The article described the enormous struggle Cuba faced in trying to ensure that its population was protected from the coronavirus pandemic. This were overwhelmingly due to the vicious over 60-year old economic warfare of the United States against its small Caribbean near neighbour, which for disingenuous reasons,  is minimised as a blockade.

Although, when the pandemic arrived, Cuba already had a good reputation for vaccine manufacture (including with the World Health Organisation), the sheer harshness of this economic warfare meant that Cuba had to go to extraordinary lengths to get the raw materials it needed for production.

The extent of this warfare even meant that its strongly community based  health system faced a shortage of syringes and had to appeal internationally for donations (with success due to international solidarity).

The Washington Post reports Cuban scientists saying that this vaccine development experience might become a case study of how poorer countries can invent their own vaccines.

The Co-Director of the Texas Children’s Hospital Centre for Vaccines is quoted wryly observing that “They were not privy to the gazillion dollars some of these [pharmaceutical] companies received.” She referred to multinational companies like Pfizer and Moderna before noting “Sometimes, with very little, you can get very far.”

Cuba’s achievement went very far with very little in part because it was not starting from scratch. In the 1980s Fidel Castro recognised that economic warfare made Cubans especially vulnerable to disease and viruses.

He invested heavily into developing a new biotech industry that included students studying abroad and establishing a ‘scientific pole’ of around 50 research institutions and enterprises around Havana. This made Cuba scientifically well prepared for the pandemic in 2020.

Collaborative lung cancer vaccine

Meanwhile, away from the pandemic, Cuba is developing a therapeutic vaccine against lung cancer, according to a recent article published in Gramma English (6 August) Cuban lung cancer vaccine helping American patients at advanced stages. Surprisingly, is making its way in the land of its economic aggressor, the United States.

After more than two decades of development, Cimavax-EGF has shown satisfactory results in patients in advances stages of lung cancer. Patients who have received the vaccine are recovering and may have the prospect of survival in normal conditions for at least the short-term.

What makes this initiative particularly interesting is that the Cuban Centre for Molecular Immunology is collaborating with the Roswell Park Cancer Research Centre in Buffalo, upstate New York close to the Canadian border.

This led to the creation of the Innovative Immunotherapy Alliance, a biotechnological company that is the only joint venture between Cuba and the United States. The result was facilitation of Cuba’s access to essential equipment and chemicals (reagents) which could not otherwise be readily obtained because of the US economic blockade.

Cuban lessons for Aotearoa

Cuba has a population over 11 million compared with over 5 million in New Zealand. As of 16 August Cuba reported 72 new Covid-19 cases and no deaths. In fact, there have been no Covid-19 deaths for over three months; an extraordinary achievement.

Compare that with New Zealand on 24 August: 3,140 new cases and a rolling seven day daily average of 7 deaths. Until very recently Aotearoa was regularly recording around 10-20 deaths daily.

One factor explaining the difference is that, by comparison, Cuba has maintained strong public health measures whereas since last October New Zealand has become increasingly laissez-faire. But vaccination levels are also important.

As of 22 August, New Zealand’s fully vaccination rate per total population (two doses or more) was high by international standards – 81% compared with 63% for the world; it also compares favourably with big economies like Germany (76%) and United Kingdom (74%) and a little less favourably with Australia (85%).

What about Cuba? Its fully vaccination rate was 88% (equal with Singapore). Compared with New Zealand, proportionately more Cubans have had more than two doses. With such a transmissible variant as Omicron, the vaccines developed to date can’t prevent transmission.

However, these vaccines can reduce hospitalisation and deaths. But, at a certain point, the higher the vaccination rate, especially when it reaches the level of Cuba’s, the scope for transmission reduces.

At some point, in mid-2020, the government was considering that the country should develop its own Covid-19 vaccines. For reasons of exigency, understandable at the time, it switched to purchase agreements with international pharmaceutical companies.

But, whereas vaccines are an essential public good, private pharmaceutical companies are driven by profit-maximisation which often leads to venal behaviour. Witness the attempts by Moderna and other companies to undermine patient rights through patent control in the early days of the pandemic: Big Pharma puts profits through patents ahead of patient rights.

While many believe that Aotearoa is over the pandemic, the pandemic is not over Aotearoa. It is time for the government to reconsider the country developing our own vaccines. Afterall, we have much expertise in this area and we already produce animal vaccines.

For New Zealand to produce its own vaccines international collaboration of some form would be required. What about discussing this with another small country with a well-proven track record starting with the Cuban ambassador Edgardo Valdes.

Nothing to lose by this and much to gain. After all, if a cancer research company in Buffalo can collaborate with Cuba, why not New Zealand!

As the iconic Ed Hillary famously said, ‘nothing ventured, nothing gained’. And if New Zealand ventures and gains, then we can adapt another famous Hillary saying . His first words when he returned to camp after he became the first person to climb Mount Everest were “we knocked the bugger [mountain] off”.

If Aotearoa learns from Cuba and explores vaccination development, we might be able to say “we knocked the bugger [pandemic] off”.

© Scoop Media

Ian Powell

Otaihanga Second Opinion is a regular health systems blog in New Zealand.

Ian Powell is the editor of the health systems blog 'Otaihanga Second Opinion.' He is also a columnist for New Zealand Doctor, occasional columnist for the Sunday Star Times, and contributor to the Victoria University hosted Democracy Project. For over 30 years , until December 2019, he was the Executive Director of Association of Salaried Medical Specialists, the union representing senior doctors and dentists in New Zealand.

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